Assignment: Lab Assignment: Assessing the Genitalia and Rectum.

Patients are frequently uncomfortable discussing with healthcare  professional’s issues that involve the genitalia and rectum; however,  gathering an adequate history and properly conducting a physical exam  are vital. Examining case studies of genital and rectal abnormalities  can help prepare advanced practice nurses to accurately assess patients  with problems in these areas.In this Lab Assignment, you will analyze an  Episodic note case study that describes abnormal findings in patients  seen in a clinical setting. You will consider what history should be  collected from the patients, as well as which physical exams and  diagnostic tests should be conducted. You will also formulate a  differential diagnosis with several possible conditions.

To Prepare

Review the Episodic note case study your instructor provides you for  this week’s Assignment. Please see the “Course Announcements” section of  the classroom for your Episodic note case study.Based on the Episodic  note case study:

Review this week’s Learning Resources, and consider the insights they  provide about the case study. Refer to Chapter 3 of the Sullivan  resource to guide you as you complete your Lab Assignment.

Search the Walden library or the Internet for evidence-based resources to support your answers to the questions provided.

Consider what history would be necessary to collect from the patient in the case study.

Consider what physical exams and diagnostic tests would be  appropriate to gather more information about the patient’s condition.

How would the results be used to make a diagnosis?

Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

The Lab Assignment

Using evidence-based resources from your search, answer the following  questions and support your answers using current evidence from the  literature.

Analyze the subjective portion of the note.

List additional information that should be included in the documentation.Analyze the objective portion of the note.

List additional information that should be included in the documentation.

Is the assessment supported by the subjective and objective information? Why or why not?

Would diagnostics be appropriate for this case, and how would the results be used to make a diagnosis?

Would you reject/accept the current diagnosis? Why or why not?

Identify three possible conditions that may be considered as a differential diagnosis for this patient.

Explain your reasoning using at least three different references from current evidence-based literature.

Case Study

Subjective:

•CC: “I have bumps on my bottom that I want to have checked out.”

•HPI: AB, a 21-year-old WF college student reports to your clinic  with external bumps on her genital area. She states the bumps are  painless and feel rough. She states she is sexually active and has had  more than one partner during the past year. Her initial sexual contact  occurred at age 18. She reports no abnormal vaginal discharge. She is  unsure how long the bumps have been there but noticed them about a week  ago. Her last Pap smear exam was 3 years ago, and no dysplasia was  found; the exam results were normal. She reports one sexually  transmitted infection (chlamydia) about 2 years ago. She completed the  treatment for chlamydia as prescribed.

•PMH: Asthma•Medications: Symbicort 160/4.5mcg

•Allergies: NKDA

•FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD

•Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

Objective:

•VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs•Heart: RRR, no murmurs

•Lungs: CTA, chest wall symmetrical

•Genital: Normal female hair pattern distribution; no masses or  swelling. Urethral meatus intact without erythema or discharge. Perineum  intact. Vaginal mucosa pink and moist with rugae present, pos for firm,  round, small, painless ulcer noted on external labia

•Abd: soft, normoactive bowel sounds, neg rebound, neg murphy’s, neg McBurney

•Diagnostics: HSV specimen obtained

Assessment:•Chancre

Plan: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

NOTE: THIS IS THE LINK TO DOWNLOAD THE BOOK:

https://www.sendspace.com/file/3dx3zx

CHECK THE ASSIGNMENT FOR PLAGIARISM

Write a paper of 500-750 words (not including the title page and reference page) paper for your proposed evidence-based practice project solution. Address the following criteria:

1. Proposed Solution: (a) Describe the proposed solution (or intervention) for the problem and the way(s) in which it is consistent with current evidence. Heavily reference and provide substantial evidence for your solution or intervention. (b) Consider if the intervention may be unrealistic in your setting, too costly, or there is a lack of appropriate training available to deliver the intervention. If the intervention is unrealistic, you may need to go back and make changes to your PICOT before continuing.
2. Organization CultureOrganization Culture: Explain the way(s) in which the proposed solution is consistent with the organization or community culture and resources.
3. Expected Outcomes: Explain the expected outcomes of the project. The outcomes should flow from the PICOT.
4. Method to Achieve Outcomes: Develop an outline of how the outcomes will be achieved. List any specific barriers that will need to be assessed and eliminated. Make sure to mention any assumptions or limitations which may need to be addressed.
5. Outcome Impact: Describe the impact the outcomes will have on one or all of the following indicators: quality care improvement, patient-centered quality care, efficiency of processes, environmental changes, and/or professional expertise.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin.

Upon receiving feedback from the instructor, refine “Section D: Solution Description” for your final submission. This will be a continuous process throughout the course for each section.

Review the Institute of Medicine (IOM) report: “The Future of Nursing: Leading Change, Advancing Health,” focusing on the following sections: Transforming Practice, Transforming Education, and Transforming Leadership.  Write a paper of 750-1,000 words about the impact on nursing of the 2010 IOM report on the Future of Nursing. In your paper, include:

1.The impact of the IOM report on nursing education.

2.The impact of the IOM report on nursing practice, particularly in primary care, and how you would change your practice to meet the goals of the IOM report.

3.The impact of the IOM report on the nurse’s role as a leader.  Cite a minimum of three references.  Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Details:

In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. Being able to articulate the information and successfully summarize relevant peer-reviewed articles in a scholarly fashion helps to support the student’s ability and confidence to further develop and synthesize the progressively more complex assignments that constitute the components of the course change proposal capstone project.

For this assignment, the student will provide a synopsis of eight peer-reviewed articles from nursing journals using an evaluation table that determines the level and strength of evidence for each of the eight articles. The articles should be current within the last 5 years and closely relate to the PICOT statement developed earlier in this course. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project. Use the “Literature Evaluation Table” resource to complete this assignment.

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.